Five Takeaways: Why Doctors Stay Mum About Mistakes Their Colleagues Make
As I wrote this earlier month, doctors often know when a patient has been the victim of a medical error – sometimes before the patient does.
But too often they don’t say anything about the mistakes, according to a recent report in The New England Journal of Medicine. Feedback to the post was so thoughtful that ProPublica decided to host a Google + hangout about the topic. We invited four experts to join us – two doctors and two patient advocates.
Here are five takeaways from the conversation.
1. The stakes couldn’t be higher for patients.
Patient advocate Patty Skolnik said that when her son went into surgery, a young doctor who disagreed with the need to do the procedure excused himself from participating but did not say anything to her or the surgeon about the surgery being unnecessary. Her son later died because of injuries sustained in the surgery. Because of the doctor’s silence, “We lost a child,” Skolnik said. So conversations between doctors about medical mistakes can be issues of life and death, she said.
2. Doctors know this is a problem.
Dr. Tom Gallagher, an internist and professor at the University of Washington School of Medicine and lead author of the NEJM study, said he has given more than 200 presentations to doctors about patient safety problems. He said the most physicians often ask him about mistakes by colleagues. “I understand I need to tell the patient about my own mistake,” Gallagher said the doctors tell him, “but what am I to do if I’m aware of a mistake that a colleague has made involving the patient that we’re caring for together. Should I say anything to the patient?”
This uncertainty suggests that doctors too often stay quiet, which means patients are kept in the dark and opportunities to learn and improve the quality of care are lost, Gallagher said.
3. Doctors stay silent for many reasons.
Gallagher said that doctors who suspect a colleague has made a mistake may be uncertain about what happened. They worry about having an awkward conversation with a peer, or about causing a lawsuit or losing a business relationship. Dr. Brant Mittler, a cardiologist and attorney who also represents doctors, said the way doctors review one another’s work is often political. Doctors who have complaints filed against them may be unfairly treated during peer reviews, he said. “The threat of professional ruin is enough to keep doctors from confronting their colleagues,” he said.
Staying silent often means that patients have a hard time getting the care they need after they’ve been the victim of a medical error, said patient advocate Helen Haskell, whose son also died because of a medical error. “When there’s been harm, patients are bounced from one doctor to another trying to find care,” Haskell said.
4. There is a way forward.
Gallagher said the rights of patients and families are more important than the fears doctors have about difficult conversations. As such, physicians are obliged to explore potential errors with their colleagues, not ignore them, he said. The commitment to addressing physician errors directly is also the responsibility of the leaders at medical facilities, he added. “Ultimately we’re calling on physicians and organizations to recognize that accountability and transparency is truly a shared responsibility,” Gallagher said.
5. Putting patients first is a moral and ethical issue.
“Patients are the ones who are putting their lives on the line and the ones who are footing the bill,” Haskell said. They have a right to expect the services for which they contracted.
Skolnik said patients have a right to hear the truth from their doctors. Patients understand that doctors sometimes make mistakes, but they need to be told what happened and what’s being done to keep it from happening again. There’s no wiggle room for doctors, she said.
Have you or a loved one been harmed while undergoing medical care? Please complete ProPublica’s Patient Harm Questionnaire.
Are you a medical provider who wants to inform ProPublica’s reporting? Please complete our Provider Questionnaire.
More than 1 million patients suffer harm each year while being treated in the U.S. health care system. Even more receive substandard care or costly overtreatment.
The Story So Far
Too many patients suffer harm instead of healing in U.S. medicine. That’s why ProPublica’s reporters have investigated everything from deadly dialysis centers and dangerous hospitals to the failure of state boards to discipline incompetent nurses.
This page allows patients, providers and readers to join the patient safety conversation. Our goal is to find out why so many patients are suffering harm and highlight the best ways to solve the problem. Here you’ll find regular updates, and places to share your stories, views or expertise.
Read all of our posts on patient safety, and find out how to get involved.
Got a tip? Fill out our form.
Share Your Story
Your input can help ProPublica's reporting.
Have you worked in health care? Tell us what you’ve observed about patient safety.
Have you or a loved one been harmed? Tell us about it.
Join the Discussion
Join the over 1,500 members of ProPublica's Patient Harm Group to learn, share your story and connect with others.
Icon graphics courtesy of the Noun Project.
Latest Stories in this Project
- Beyond Ratings: More Tools Coming to Pick Your Doctor
- Rocky Mountain High or Reefer Madness? Legal Pot in Colorado Comes with Risks
- So You’ve Become a Patient Safety Statistic – Now What?
- Ad Endorsing da Vinci Robot Violated U of Illinois Policies, Review Finds
- One Third of Skilled Nursing Patients Harmed in Treatment
Our Hottest Stories
- Segregation Now
- Long After Sandy, Red Cross Post-Storm Spending Still a Black Box
- Even After Doctors Are Sanctioned or Arrested, Medicare Keeps Paying
- How the Labor Department Has Let Companies Off the Hook for Unpaid Internships
- Shake-Up Inside Forensic Credentialing Org
- The U.S. Government: Paying to Undermine Internet Security, Not to Fix It
- Meet the Doctor Who Gave $1 Million of His Own Money to Keep His Gun Research Going
- Republicans Say No to CDC Gun Violence Research
- MIA In The War On Cancer: Where Are The Low-Cost Treatments?
- What Newly Released Docs Tell Us About the IRS and How It Handles Dark Money Groups